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Introduction
 
 
 
 

Chapter 30 – Toothpaste Tube of (almost) Death

It all started two days before Christmas 2011. I came home and there was brown vomit in Gabby’s crate, and the room smelled like poop.
I called Darlene.  “Did Gabby have an accident when you where here?”  “No,” came the reply.
I cleaned it up and forgot about it.  Later that evening, Gabby jumped off the bed.  She crawled under the bed, came back out and then jumped back up on the bed with something in her mouth, something I could not recognize.  It was plastic and chewed beyond recognition.
“That isn’t one of your toys,” I thought.  I took it out of her mouth, looked closely but still did not recognize it.  She had gotten something she wasn’t supposed to have, but the question was… what was it?
I got down on the floor and looked around for clues.  I finally found a tiny piece of something, a flake barely bigger than a pinhead.  It had a blue letter on it.  Recognizing the color, I pulled out a tube of chicken-flavored dog toothpaste from the drawer.
It matched. The letter was from the back side of the toothpaste tube.
Where did she get it? I saw my overnight bag with an open pocket on the floor of the bedroom.  I looked in and saw a toothbrush, but no toothpaste tube.
I quickly put it all together.  My dad had been watching her for the past three days when I was visiting my mom in South Carolina.  Apparently in the middle of the night she jumped down off the bed, got the tube out of the bag, took it under the bed and ate the delicious chicken-flavored toothpaste.
I looked under the bed for the rest of the tube.  I found nothing.
Not only had she eaten the toothpaste, she had eaten an entire tube made out of metal foil and plastic.  I later discovered that her life had been in real danger earlier that day.  Vomit with a poop smell is a warning sign of an internal blockage. Fortunately, she cleared it on her own.
I called my local veterinarian’s office to make an appointment.  They did not seem too concerned.

“We’ve seen dogs eat an entire television remote control and pass it all,” the vet tech said. “Does she seem in any discomfort, or is she throwing up now?”

“No,” I replied.
“Then just keep a close eye on her and check her stools to make sure it is getting passed through her.  If she seems in any distress or throws up, then bring her in right away.”
Her next stool was filled with crinkly foil. I hated seeing that!  But she went on this way for a week, passing it without incident.
I came home on New Year’s Eve.  She had thrown up some yellow foam.  So, it was off to the Castle Shannon VCA ER this time for x-rays.
The ER did x-rays.  The veterinarian showed me that the lower colon still had some sparkly-looking metal foil in it, but upstream it all looked clear.  There was food in her stomach so they could not tell if she had any fragments remaining there.  Still, it looked like the rest would pass through soon and the whole worrisome episode would be over.
I saw the last bit come out the following day, and the next stools where clear. Then, on Jan. 2, she threw up first thing in the morning.  It was off to my regular, local vet for X-rays again.
Local vet’s evaluation and prescription…
She had an empty stomach this time and the X-rays showed that she had something in her stomach, or at the opening of the intestine.  They could not tell where exactly it was,or how big it was  The suggestion: feed her bread coated with Vaseline, so the foreign material would stick to the Vaseline and get pushed through her system.
I told the vet I did not like this idea.  “We don’t even know how big it is.  It’s been in there a week and hasn’t gotten through on its own.  Don’t you think forcing it through is a bad idea?”
“Well, if it doesn’t work we can do surgery,” was the reply.
“So you are going to cut open her stomach?” I asked.
“Yes, and her intestines too so we make sure we get it all,” was the answer.
This was looking worse and worse.  I asked, “And if we do the Vaseline bread, and it gets stuck in her intestines, what then?”
“Then you have to get her into emergency surgery right away, or she will die.”
I was composed for the most part during this conversation, but inside I was very agitated and angry at these suggestions. It seemed reckless and illogical. There had to be a better way, and I quickly focused on finding it.  Looking at her mouth and stomach… they were less than a foot from each other… then drawing from my experience with Olympus cameras, a light bulb went off in my head.
“Do you have an endoscope?” I asked.
The veterinarian froze up, seeming to not like this idea. “No, I don’t… and besides, that doesn’t always work, just because things go down the throat, that does not mean they will come back up through the throat.”  The vet did not like my suggestion at all, when I thought it was very logical.  I did not think someone would shoot down my idea just because they did not have the equipment.  After all, aren’t you supposed to look out for the patient first, and refer to a specialist if necessary?
“Yes, but even if it does not come out, we will at least know what it looks like and what we are dealing with,” I argued.  We went back and forth about it for a while, then I took Gabby and left, with the final suggestion from them to try the Vaseline bread and then surgery.
Does Doc have an endoscope?
It was starting to snow when I called my mom from the parking lot.  She did not like the Vaseline bread idea either.  “What about your doctor in Ohio?” she asked.
“I’ve been thinking about that too,” I replied. “I am calling him right now.”
I called and Mallory answered.  “Does Doc have an endoscope?” I asked.
“Yep, and he’s using it right now!” Mallory replied.
I explained the situation and they said they would see us as soon as we got there. I got a copy of the latest x-rays from the local vet and four hours later we were in the Meadowlands office, an hour before closing. It was snowing heavily on the way to Cleveland, but I was determined to bring this situation to an end as soon as possible. Armed with my trusty Blizzaks on all four wheels, I knew we would make it there.  I knew I could spend the night there if the weather got worse. 
Doc looked at the x-rays and said he thought something was still in the stomach or in the opening to the small intestine. He said he would go inside and take a look with his endoscope, and that it was worth a try.  Fortunately he had done her dental eight months prior, had all her vital stats and had experience with her under anesthesia, so I was not worried about her going under this time. If whatever was in there did not come out via endoscopy, at least we would know what we were dealing with and that surgery was unavoidable.

endoscope
Doctor Slobody’s endoscope

Fortunately, surgery was not needed. Forty-five minutes later a vet tech came out of the OR, smiling.  “We got three big pieces,” she said.  “We got it all.”
 

endotool

One of the tools Doc used to remove the debris from Gabby’s stomach

Doc came out shortly thereafter and showed me video from the endoscopy. Her stomach looked like wrinkly like a brain inside, I never knew!   “There were three big fragments that kept getting tossed up whenever she ate, then they settled at the opening of the small intestine,” he explained. “I am surprised there was no real irritation to speak of. We filled her stomach with air, then I used my endoscope’s hook and basket to get the objects out. I had the vet tech reach under and move her body little by little to help get them in position so they came out easier. After we finished I gave her a shot so she won’ be nauseous, but she will be tired the rest of the evening.”

 

pieces

Penny is for scale. You can see some of Beni’s fur, which stuck to her toys and she ingested it

He gave me a plastic baggie with the fragments.  Any one of them would have killed her by blocking or lacerating her intestines had they made it any further into her system.  One of them looked particularly scary.  It was like a little pyramid with a sharp point on each corner.  When I saw it I thought, “Gabby death dart.”
I reflected on what had happened. The Vaseline bread would have meant a painful death, and cutting open a 14 year-old dog’s internal organs was not a great idea, either. She may never have been the same, and there could have been complications, infection and certainly as a lot of pain and recovery time.  I later looked up the cost for the surgery.  It would have probably been around $3,000 and she would have been in the hospital for several days, plus a long recovery at home.

The endoscope procedure cost around $649 and Gabby slept peacefully in my lap all the way back to Pittsburgh. Fortunately, the snow had slowed down and we made good time.  When we got home three hours later, she was knocking her toy around and playing like nothing ever happened.  So much for Doc’s, “She will be tired the rest of the evening.”  

I reflected on the doctors and the two different outcomes. What a difference!
Besides the quality of the care, Doc and his staff had gotten to know and befriend us, and his abilities and the equipment he had were far beyond any veterinarian or animal hospital I had ever seen. In fact, that is how I found him…looking for cryosurgery, and his was the nearest facility I could find that had it. He had also found the cracked tooth with his optical probe, when her regular vet had missed it, and always had the answers when I asked.  
Believe me, when you give someone your beloved dog and her stomach is full of life-threatening metal shards, and 45 minutes later you get her back with the shards removed like it was nothing at all, it makes an impression on you.
At this point, there was no question about it. I wasn’t going back to my regular vet, no way, not after this near disaster. I was very happy with Castle Shannon VCA as my local ER, so that would stay the same. However, Dr. Slobody was going to be our regular veterinarian, even if we had to drive 282 miles round-trip to see him. I wanted his skills and technology on our side. 
They say you should trust your instincts.  My gut feeling using him for the dental had just paid off… big time.